low tsh feel good

[mary00777]

My tsh is .04.  My levxoyl was lowered to 88 2 weeks prior to this.  I had been on 112mg in November and then 100 in January, then to 88 in late March.  I felt great from Nov- to now.  Now I feel lousy.  Exhausted, brain fog,achy.  The docs office tells me it can't be the new dosage because it's too soon.  Rather they tell me it's due to the earlier dosages.  This goes against what my body is telling me and common sense.  How can this be?  Makes no sense.  Office has no time or patience to explain. Should I ask for the Free T3 & T4 test?
I think I may need a new doc. Thank you.

[gimel]

I disagree with your doctor about the med change.  Even with a T4 med, 2 weeks is long enough to feel a difference.  I also disagree with using TSH only as a way to determine your med dosage.  

TSH is a pituitary hormone that is affected by so many variables that it is a poor diagnostic by which to determine medication.  Unfortunately many doctors have the "Immaculate TSH Belief" and want to use it that way.  At best TSH is an indicator, to be considered along with more important indicators like symptoms and also the levels of the actual, biologically active thyroid hormones, free T3 and free T4.  FT3 is actually the most important test because FT3 is four times as active as FT4, plus FT3 correlates best with hypo symptoms.  TSH does not correlate well at all with hypo symptoms.

When taking significant thyroid meds, it is not at all unusual for a patient to have TSH suppressed to the low end of the range and below.  Although doctors frequently will pronounce you as hyper and want to reduce your meds, you are not really hyper unless you also have hyper symptoms.  Symptoms really define whether you are hyper, or Euthyroid, or hypo.

In my opinion the very best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with whatever medication is necessary to relieve symptoms, without being constrained by resultant TSH levels.  Frequently members here report that symptom relief required that FT3 was adjusted to the upper part of its range and FT4 was ajusted to at least the midpoint of its range.

So, yes I would insist on testing for FT3 and FT4.  I would also tell the doctor that you want to be treated for your symptoms by testing and adjusting FT3 and FT4 levels as necessary.  If you cannot convince your doctor of treating you this way, then you may as well start looking for a good thyroid doctor that will.

Here is a good link that you might find useful in trying to convince your doctor to treat your symptoms, not your TSH level.

http://www.hormonerestoration.com/Thyroid.html

[redheadaussie]

Hi there. It is not just the TSH you should be guided by. You might find that your Free T3 is low and might need a T3 supplement. Do you know what your Free T4 and Free T3 levels are? FT4 shows how much thyroxine is in your system and the FT3 shows if is it working. If you are low on FT3 you will have the symptoms you describe, regardless how 'good' your TSH numbers are.
Yes, you need a new doc!
Good luck!